Good morning, everyone, and thank you for being here. Welcome to our outstanding session titled Success for Mid-Career Radiologists Across the Board, Research, Education, and Leadership. My name is Jadronka Stojanovska, and I'm an associate professor of radiology at NYU. And it's my pleasure to moderate this session alongside with my co-moderator. My name is Auva Grubstein. I am also an associate professor in Tel Aviv University and a breast radiologist. It's a pleasure. Excellent. So what we're going to do, and the way we have designed this session, is that we have three outstanding speakers who are going to give talk for about 10 minutes, followed by panel discussion in the last 25 minutes. And we will also open questions that are coming from the audience. So with no further ado, I would like to present our first speaker, Dr. Charlotte Young-Hink, who is the leading expert in radiology, currently serving as vice chair of equity, diversity, and inclusion, and clinical associate professor at the Department of Radiology, University of British Columbia. Her topic is succeeding in the transition from early to mid-career. Thank you. At the end of this talk, you will be able to explain why mid-career is a pivotal time in one's professional life, suggest effective methods for setting clear and achievable goals and building a strong professional network, offer strategies for developing leadership skills and managing work-life integration. So picture yourself at a crossroads in your radiology career. The years of early achievements and the drive to establish your expertise have brought you to a point where new challenges and responsibilities await. You are transitioning to mid-career. Suddenly, your role expands beyond individual accomplishments to include leadership positions, mentoring the next generation of radiologists, and actively shaping the goals of your institution. As your roles at work evolve, you may also be facing health issues or changing family dynamics. This can be a stressful time, but it holds potential for new opportunities. Typically occurring 10 to 15 years after training, mid-career brings a mix of professional and personal challenges. This phase necessitates reassessing career trajectories and personal growth, often involving the challenge of balancing professional growth with family obligations such as raising children or caring for aging parents. While personal lives progress, many experience stalled career advancement or careers do advance but often at the expense of family time. Women and minority physicians face additional challenges during this phase, and a disproportionate number of women and minorities either choose or feel forced to leave academic medicine. For women and individuals from underrepresented groups, the minority tax adds the burden of extra expectations to represent diversity on committees or panels, leading to increased workloads without adequate compensation or recognition, which can result in burnout and decreased retention. Bias and unfair treatment further complicate these issues. The departure of diverse mid-career radiologists from academia represents a significant loss for both the field and patient care, perpetuating inequities in leadership roles and pay. Transition periods are ideal for reflecting on goals. In the early stages of a career, objectives may have focused on securing a dream job or building expertise. However, in preparation for mid-career, it's important to re-evaluate what success means now. This reflection should include assessing personal values and aligning them with desired professional and personal achievements. SMART goals – specific, measurable, attainable, relevant, and time-bound – can be continuously reviewed to ensure they align with evolving career visions and personal circumstances. Setting both short-term and long-term goals is essential. Short-term objectives might include earning a promotion or introducing AI to your department, while long-term ambitions could involve shaping your department's direction, influencing policy change or advocacy. In addition to professional aspirations, it's equally important to establish personal goals, such as training for a marathon or pursuing a new hobby. As life evolves, goals may need to adapt, which is fine. Building a strong professional network is important at all career stages, especially during mid-career, a phase that is often overlooked. This period is an opportunity to connect actively with peers, mentors, and senior radiologists and professionals from other specialties. Conferences like RS&A provide valuable chances to meet new people and maintain connections. Networking involves deepening existing relationships and actively seeking mentors who can assist with different career facets. Establish a mentor team with diverse expertise. Mentors can come from a variety of backgrounds. The focus should be on finding individuals with the right knowledge and experience. Make time for regular contact with mentors. Mentors can include senior colleagues, peer mentors, and even reverse mentors – junior colleagues from whom you can learn about new technologies and research methodologies. Joining formal mentorship programs, peer mentoring groups, and professional associations can further expand your network. Peer mentoring, where you exchange experiences and advice with colleagues at a similar stage, can be particularly valuable. Mid-career often brings increased responsibilities and leadership roles, whether sought-after or not. Leadership encompasses initiative and influence, enabling you to align departmental goals with broader institutional objectives. Even without a formal leadership title, you can lead through action by guiding research projects, managing teams, or advocating for policy changes within your institution or professional society. The more leadership opportunities you embrace, the more you'll be recognized as a capable leader, opening the door for additional roles as your career progresses. Focus on developing skills through courses, workshops, certifications, or even advanced degrees like MBA or MPH. These opportunities not only help develop crucial skills, but allow for networking. Taking the initiative to participate in these programs and leading projects can showcase your leadership potential. Strong communication and conflict resolution skills become crucial as you collaborate with multidisciplinary teams and navigate complex administrative challenges. Engaging in leadership roles allows you to connect with a broader range of professionals, further expanding your network, and creating new opportunities. Instead of aiming for work-life balance, it's often more practical to focus on work-life integration. While challenging, achieving this integration can help prevent burnout and keep you resilient during difficult times. Setting boundaries is crucial. Don't hesitate to decline tasks or projects that don't align with your goals or could lead to overextension. Remember saying no is not a failure or something to feel guilty about, it's an act of prioritizing what truly matters. Focus on aspects of your job that bring fulfillment and carve out time for personal activities, whether it's family time, hobbies, or relaxation. Incorporating personal time or self-care is essential for maintaining energy and avoiding burnout. Learning to delegate and seek help is also important, especially as you step into leadership roles. Effective communication and time management can alleviate the pressures of leadership. Clearly communicating responsibilities and setting expectations within your team will create a smoother and less stressful work environment. When you're part of a reliable team, work becomes more manageable and you are less likely to burnout. Radiology, like everything, is constantly evolving. Embracing new ideas and being ready to adapt can create significant opportunities for innovation and advancement. Mid-career can be unpredictable, filled with personal responsibilities, health issues, unexpected shifts at work, such as leadership changes or departmental restructures. These circumstances may necessitate reassessing your work approach and priorities. Just because you've always worked weekends does not mean that must continue indefinitely. As your life circumstances change, it's essential to evaluate what works for you. Self-awareness is key. Recognizing when to prioritize your well-being is crucial. Flexibility and resilience will enable you to navigate the changes and challenges that arise. Understanding flexible means adjusting your focus when necessary, such as shifting to teaching if research opportunities become scarce, or exploring new subspecialties and administrative roles, only if they align with your strengths and interests. For instance, if your department undergoes significant leadership changes, being adaptable could involve actively seeking new mentors or reassessing your position within the department's new structure, rather than waiting for changes to dictate your career trajectory. By remaining adaptable, mid-career radiologists can maintain relevance and continue to contribute meaningfully to the field, even in the face of unforeseen challenges. So in summary, transitioning to mid-career is undeniably challenging, yet it presents opportunities for growth and fulfillment. By focusing on strategic goal-setting, leadership development, and building a strong network of mentors and peers, radiologists can navigate this phase with confidence and resilience. Effective communication, time management, and commitment to work-life integration are key to preventing burnout. Adapting to changes in the profession and in personal circumstances is essential. Being flexible, staying resilient, and reassessing priorities will help ensure long-term success. Mid-career isn't just about professional achievements, it's about aligning your career with a fulfilling personal life to create a sustainable, satisfying path forward. Basically, figure out what you want personally and professionally, and say no to anything that does not work towards those goals. So I'm going to talk about academic promotion and advancement, and I'd like to thank Dr. Rakeshavik Penner and the RCA Research Development Committee for the opportunity to present and share this. In this talk, I'll share why caring about promotion is crucial for career growth, my personal journey navigating the process, the challenges I faced along the way, and practical advice with actionable steps to help you achieve your own personal development. So why care about promotion? It's a public recognition of your work and expertise in the field. Not only is it personally rewarding, but it also raises the status of the department you are in, the university, and may increase the funding allocated to you or to your institution. It also helps to advance your career and provide greater career opportunities, sometimes greater job security on tenure path. And it refines your skills by learning as you go on that journey, and it increases the opportunity of exchanging ideas with other people, experts in the field, nationally and internationally, which helps advance your career as well. So my story is I was promoted to associate professor in 2007. I was promoted to full professor in the Department of Radiology in 2018, and then cross-appointed to the Department of Surgery in 2019. And I think what was actually very meaningful to me was the opportunity to share the success with my family, including my mother, who had helped me to navigate the obstacles in achieving this goal, having personally achieved promotion to full professor in the Department of Family Medicine after two prior unsuccessful attempts. And my first attempt was unsuccessful. I was advised that I had insufficient international recognition. I learned I had not planned sufficiently well, and nor had I had the right mentorship to succeed. So there are many challenges that we face when striving for academic advancement and promotion. As women in radiology, as Dr. Yong-Hing just showed, there is a leaking pipeline. And while almost 50% of women are in medical school, by the time you look at the radiology faculty, only 13% are promoted to leadership levels in radiology. This is particularly concerning because the evidence shows that if there is an applicant pool which included only one woman applying for promotion or position, she had a zero chance of being selected. Whereas if 75% of the applicants were women, there was a 67% chance of a woman being selected. So it's been proposed that you need at least 15% of representation to overcome a sense of token effort. And it bears well for us to promote other women to help actually advance all women to be promoted. But this isn't just for women. This applies even more for underrepresented in medicine, defined by the Association of the American Medical Colleges to include racial and ethnic populations that are underrepresented in the population and in the medical profession relative to their numbers in general. So while 30% of the general populations are URIMs, only 6% of radiology faculty positions in the US are held by URIMs. So this leaky pipeline is even greater in this area. So underrepresented faculty is only a part of the challenge for promotion and advancement. What I learned in my own goal was that there were two most helpful tips for me to succeed. And what I needed to achieve full professor status was to have greater international recognition. What that meant is broadening what I said yes to, accepting invitations to travel and to speak abroad. And not only does this develop relationship with experts in other communities or countries, but it also increased my skills by learning from these individuals internationally. And also some of them could serve as potential external reviewers. I also needed to incorporate a team approach to achieve my goals. That meant enlisting my family's support, my colleagues' support, making my goals known. And it meant cultivating relationships with a broader network of mentors and sponsors outside of my own institution. And that was what really allowed my goals to become possible. So some strategies for advancement are, and Dr. Jung covered on many of these, you really need to focus on your academic profile, which means documenting your research, publishing, presenting at international conferences or conferences such as the RSNA. You need to develop your leadership skills and do this by learning, by volunteering on committees in professional societies, and taking courses to really learn leadership skills. Mentors help you believe that you can accomplish your goals and provide a supportive professional network. And you must advocate for yourself and learn to do it even when it feels, or if it feels uncomfortable. I will say practice makes it easier. So a lot of people ask how many years of practice are required before applying for promotion. And a very useful study by Goswami and colleagues, including Dr. Meltzer, looked at on average instructors and assistant professors had between eight and ten and a half years of experience. Associate professors had 14 to 15 years and full professors 26 to 28 years. And what they found was that there were differences in when men and women applied for promotion. And on average, women and junior faculty positions were more experienced than men, but it became more similar for full professors. Another question that is very pertinent to this is how many publications do I need to be promoted? That is a question I'm asked often. But instead of asking how many publications are needed, a better question is what is my H-index? And many people are not aware of what the H-index is. The H-index is a metric used to measure both the productivity and the number of citations and impact of the citations of a scholar's published research. So the H-index is defined as somebody who has a certain H number of papers that have been cited a minimum of H times. So if you have ten papers that have been cited at least ten times, you have an H-index of ten. And what the H-index does is it aims to balance two factors, the quantity of the publications and their quality or impact. And, for example, the number of citation counts. So in Goswani's study, they found that gender did not influence the academic rank. It was the H-index. So the number of the H-index for instructors and assistant professors was typically between two and three. Associate, H, index of eight. And full professors, 20 to 26. And what the authors found is that the years of practice and the H-index were the strongest predictors of full professorship and executive leadership. So it's very easy to look at your H-index. You can go to Google Scholar. You must make it public. And here's my chance to promote myself to tell you. So you can then show what the number of citations is, what your H-index, and even your I-10 index, which is the number of papers cited at least ten times. And you can see that it doesn't actually matter always. The impact factor is not the most relevant feature. You might have a lot of citations in the highest impact factor journal, the New England Journal. But even in a relatively low impact factor journal, like Current Oncology, where you have a meaningful access, it can be cited hundreds of times. So each institution has its own rules. Although on average you might think about applying for promoting between five and seven years after the last, you should be using the template from your institution and listing your awards, publications, and funding and leadership and committee work. You should be thinking that to be eligible for promotion, you need to have expertise and recognition. Assistant would be local. Associate professor would be national and internationally for full professor. You will need to have letters of support from external institutions that can attest to your level of expertise. And they should be at the same level that you're aiming for or higher. You will need to write an executive summary between one and two pages, which is your story and the summary of your expertise. Notice it takes time. And this you have to devote enough time to. You should remember to be strategic in your approach. That means saying no when you when you it's not going to align with your goals, but be informed about your no and make sure you say yes to in order to rise when appropriate. The most important strategy is you want to identify your talents and you have to have a brand. You have to tell a story. And this has to be something that will resonate with your experience and values. I lost my grandmother too young to breast cancer. So my story includes promoting what I do is for early to aiming for early detection of breast cancer and reducing its morbidity and mortality. So remember, you're promoting yourself. Sorry to keep track of your awards and accolades. It's tucked away so that you can access it when you need. Go to your institution. Find out their their rules. Use the templates of your institution. And I would just say, do it. And failure is only one step forward to success. Thank you. Thank you very much. There was very insightful presentation. Now we have we're moving on to our last speaker. That's David. Dr. David Minkoff. He's the vice chair for Research Department of Radiology, vice chair for the tenure track at the School of Medicine at the University of Pennsylvania. His title is mentorship for mid-career radiologists. Thank you. And I just wanted to start by just getting to know the audience here. Who in the audience is a would consider him or herself a mid-career radiologist? Any folks in the audience that are old enough or I should say senior enough that are thinking about that are actually mentoring mid-career folks? OK, so there's a little bit of a mix here. And I will I will talk to both of those. I, in addition to having some leadership roles on the research side, I'm on our Promotions Committee in our School of Medicine and actually one of the vice chairs. So I'm a complete promotion nerd. So I will have still a promotion framework in this after Dr. Sealy's wonderful talk. So I'm going to talk a little bit about timelines and definitions. I'm here again, probably using promotion ranks as a framework. And then I want to point out how mentoring needs differ for mid-career folks than for early career folks, because you have all theoretically been through early career. So you know what it's like to do that. And I think understanding the differences of what you're looking for as both a mentee and a mentor after that is very helpful. In general, I think we do a pretty good job of finding our new assistant professors, our new faculty members and guiding them with mentorship committees. Most places do a good job of that. Once we get them through that early period where sometimes there's an up or out promotion, but there's certainly a desire to get from junior to mid-career, we kind of forget about them a little bit. And so I take from the first two speakers the idea of really both seeking out mentorship and in your institution trying to develop mentorship for mid-careers. And then I'm going to have just a quick slide at the end for a sort of tip sheet on both mid-career mentoring and mid-career menteeing. OK. So again, I'm going to define this a little bit by the timeline of promotion. So I would argue that mid-career starts somewhere around the time you become an associate professor. Some might argue with that a little bit and goes into being a full professor. But those of us that have been doing this for a while, I'd like to think I'm still a mid-career faculty member, but I'm not, will be likely or possibly within that full professor range. Again, in many places, you've got to get to associate professor to be able to stay there because there's often an up and an out. And even if that's not the case, by the time you get to associate professor, you say, OK, I've gotten here. There's not really any time pressure now. I've made it by some regard. And so it's really a time, I think, as we heard, for reflection. One of the things that comes up in the context of that second promotion is trajectory. And so in general, I think there's quite a bit of variability in when people go up for that second promotion. Some might do it as soon as four or five years in our center. Some might do it more like 10 to 15 years afterwards. And a lot of what's happening here is not only is the idea that not did you just get to associate and said, ah, what you're allowed to do and stay there, but that you can continue and perhaps even accelerate a trajectory by some measure. So let's go about through what junior versus mid-career considerations are with that context. And so I like to think about this in different processes. So for promotion, you heard a lot about this before. This can be mandatory for most tracks or some tracks at least. It's not mandatory in just about any institution to go from associate to full. So you would like to do it for all the reasons that Dr. Seely said, but you don't always have to do it. If we think about this from a clinical practice standpoint, as you're just getting started, you want to advance your skills and begin to develop your specialization if you're at an academic institution. And as you move into that mid-career phase, your next job is really to think about driving those advances, either by innovating or organizing practices or thinking about new ways of doing them. From an education standpoint, most of us have to learn how to teach and do a little bit of mentorship in that early phase, and that can be a big switch in going from trainee to trainer. And when you get to this phase, it's more and more about leading about education and being a mentor and a mentor to a number of different folks, including some of the junior faculty as you're moving forward. If you think about research, which I tend to worry about a lot, if you have a research program, whether it's an NIH-funded lab-based program or a more clinically-oriented program, you're just trying to get some research publications and funding to start with. But you want to sustain and accelerate that productivity, and you want to sustain and make advancements. Those advancements can be getting more grants. If you're a grant-based researcher, it can be more publications and more senior authorship, more senior publications. Sometimes it can be taking on new projects and new roles as a leader locally, nationally, or internationally. And then finally, there is, when you're getting started, you're thinking about just being part of the department and having an academic identity. By the time you're in mid-career, your next step, if you're going to continue to advance, will likely involve some form of leadership. Not always, but in many cases. And then you're exploring an academic identity as well, but in a new phase of your career that's at a more senior level. You're the teacher and the mentor and the senior author, and less of the person just trying to get started. So I do come back to the promotion that how you do this still, I think, depends a little bit upon your track. If you are in a tenure track, which at our institution means pretty much a funded independent investigator, then the track really requires you to focus a lot of your advancement in the mid-career on your research activities. If you are at the more clinical end of the track, which we call the academic clinician, there the focus is going to be on advancing the clinical practice, taking on educational leadership. It may not even involve publications at that point, but will involve advancing your leadership and reputation in those other fields. And if our sort of middle ground to that, which is the clinician investigator, you'll be doing both practice advancement and carrying out research and publication. So it's not quite one size fits all because it really depends upon where you are, what your goals are, and in particular what your school allows you to do in the track that you're in. All right. So let's go on to mid-career versus junior faculty needs. This is a very large table. I will step through it slowly and carefully. But again, in promotion, the specific requirements are thinking about what the requirements are for promotion, milestones, and progress. As you get to that next stage, you're usually past something you have to get to or want to get to to feel like you've made it. And this is much more about goals and desire, trajectory, leadership, recognition. Again, we start in clinical practice. We're thinking about quality and productivity, your interaction with the clinicians. Should I be developing specific expertise within my subspecialty? When you get to mid-career, you're supporting other people's productivity. You're seen as the expert by clinicians. You've established that and you're helping others to do that. And you're really looking for development and innovation in your practice, especially if that's one of your focus. Again, education, you're putting your lectures together. You're figuring out how to teach residents in the clinic. Do you have any special interests in teaching that you want to move forward with? You then move into a senior person where you're seen often as the topic authority in your institution and sometimes around the world. You're an advisor and a teacher. You're doing program leadership, especially if education is your focus. From research, just to spend a lot of time, I think, in junior faculty at defining these areas of research, we tell you to be very narrow and focused. But as you get more senior, you're thinking about program expansion. You're thinking about expanding your collaborative network, having leadership in the lab and leadership across the system. And then finally, when you get started, you're just finding your collaborations. You're defining what your academic mix is, what you think you like to do, because it's really hard to know what that is when you're a trainee and a resident. And you're looking for areas of emphasis. As you think about that last stage, you're moving from participation to leadership, from just getting started and figuring out your mix to figure out how you want to refine your mix. And then thinking about how to develop, as Dr. Seely said, a national and sometimes international reputation. Okay. So just to summarize, the mid-career mentoring needs by track, then, are going to differ. And I won't go through all of this in the interest of time. But it will depend upon whether you're research-focused, whether you're focused in the clinical process and education, or whether you're in the clinician-investigator track. And all three of these tracks will have educational roles, but those will be different in the three. So I'll close with – I just want to forget about long-term goals and leadership. One of the things I think you want to decide about at this point is whether or not you want leadership and how you want it. So I'll close with two very quick tip sheets here to make sure we have enough time to talk. If you are a mid-career mentor to a mentee, work from the base of success on promotion, want to find out what the mentee finds enjoyable and valuable, what would they like to accomplish in the next five to ten years, and what are you thinking about as the span of your career? Because sometimes you'll get to somebody like me who's at the senior end of their career. What do you want to do and what do you need to get there? From the mentees, I've made it past promotion. What do I want to do next? I can take a breather for a second. What's my vision for advancing the field in practice and research? How do I get to where I want to be? How can I help make this happen? It's no longer other people helping you necessarily as much as you're helping yourself. How can I help others to succeed? Do I want a leadership role? And what do I want people to say about my career when you get closer to the end of the career? And the mid-career is a good time to think about that. So with that, I will stop. And thank you, and thank you again for being invited to participate in this.

mid-career radiologists

career transition

leadership

mentorship

work-life balance

professional networking

academic promotion